Usually suspected by a decrease in platelet count though thrombosis may be the presenting complaint.

Laboratory diagnosis involves assays for HAT antibodies which are either:

1. functional assays: measure heparin dependent platelet activation

• 14C Serotonin Release Assay

• platelet aggregation test

• heparin induced platelet activation test (HIPA)

2. antigen assays (ELISA technique): measure IgG, IgM, IgA antibodies Note the following:

• HIPA assay, 14C Serotonin Release Assay, PF4/Heparin ELISA are sensitive assays for the detection of HAT II antibodies.

• The clinical relevance of HIT II antibodies without clinical symptoms is unresolved. Screening of patients for HAT II antibodies cannot be recommended currently.

• With clinical symptoms and decreased platelet count the detection of HAT II antibody is important for diagnosis and future management.

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